A comparison of the neuropathological effects of vigabatrin and carbamazepine in patients with newly diagnosed localization-related epilepsy using MR-based cerebral T2 relaxation time measurements.
BACKGROUND
Magnetic resonance (MR)-based T2 relaxation time measurement is a sensitive technique to detect neuropathological changes such as intramyelinic edema in vivo.


OBJECTIVE
To determine whether vigabatrin (VGB) causes an increase in T2 relaxation time in patients with newly diagnosed localization-related epilepsy over 1 year.


METHODS
Patients with newly diagnosed localization-related epilepsy who participated in a VGB-carbamazepine (CBZ) monotherapy trial were included. All were scanned on a 1.5 T Siemens SP63 Magnetom scanner. T2 maps of the brain were obtained at baseline and at follow-up 1 year later. Nine control subjects had repeated hippocampal T2 maps with a median interval of approximately 2 years.


RESULTS
23 patients (12 on VGB and 11 on CBZ) were included. There were no increased T2 relaxation times in the VGB treated group at follow-up and no significant differences between the two antiepileptic drug groups. There was a trend for the temporal and frontal white matter T2 relaxation times to be lower on follow-up in the patients compared to the control subjects.


CONCLUSIONS
The findings do not suggest that intramyelinic edema occurs in patients taking monotherapy VGB for 1 year.
Van Paesschen
W
W
University Department of Clinical Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
Duncan
J S
JS
Connelly
A
A
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D002220:Carbamazepine / Q000627:therapeutic use*; D002531:Cerebellum / Q000502:physiology; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005625:Frontal Lobe / Q000502:physiology; D006624:Hippocampus / Q000502:physiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016037:Single-Blind Method; D020888:Vigabatrin; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000927:Anticonvulsants; D002220:Carbamazepine; D005680:gamma-Aminobutyric Acid; D020888:Vigabatrin